Anti-inflammatory drugs currently used to treat diseases such as rheumatoid arthritis may also help prevent cognitive problems after surgery, according to a new study by researchers at Imperial College London and University of California, San Francisco (UCSF).
The research also reveals for the first time that a specific inflammatory response in the brain may explain why many patients experience memory loss or other forms of cognitive dysfunction after surgery or critical illness. For years, anaesthesiologists and neurologists have struggled to explain why some patients, especially the elderly, experience confusion, learning disorders and memory loss after surgery – referred to as post-operative cognitive decline. While typically short-term, this delirium occurs widely in intensive care units, affecting between 28% and 92% of hospitalised patients, depending on their age, health status and type of surgery. It has also been linked to poorer surgical outcomes, as well as an increased risk of mortality, inability to cope and possible permanent dementia. Until now, researchers have not clearly understood what causes the disorder or how to treat it. The new research suggests that it is caused by cell-to-cell signalling molecules called cytokines released by cells of the immune system. There are drugs already in use that target the activity of cytokines so it is possible that these drugs could be effective against cognitive decline. According to the researchers, the findings from mouse models could lead to human clinical trials within a year. The study was supported by the Westminster Medical School Research Trust, in London, the Mathilda and Terence Kennedy Institute of Rheumatology Trust, and Arthritis Research UK.
